Peripheral Neuropathy: Pathogenic Mechanisms and Alternative Therapies
this full text paper has some interesting thoughts on Neuropathy.
I'm sure you are already aware of the role of vitamin D3 in helping Peripheral Neuropathy.
there are lots of other good reasons to make sure Vitamin D status is kept high.
There are lots of other suggestions in that article that deserve consideration such as
The role of alpha-lipoic acid in diabetic polyneuropathy treatment.
Role of acetyl-L-carnitine in the treatment of diabetic peripheral neuropathy
I'd concentrate on those suggestions that appear to provide not only specific benefits for diabetic neuropathy but multiple health benifits generally. For example as we know that low magnesium levels are associated with problems in diabetes ensuring we had optimal magnesium intake this would be not only a good idea generally but also may be particularly helpful for neuropathy.
But do take note of the time scales involved. Our body has trillions of cells and the rate of repair/maintenance turnover is slow. With omega 3 - vitamin D3 ect we first have to correct deficiency status, that may take 3months if we use an effective amount, only then will the bodies stores build and the gradual rebuilding of cells to the original DNA specification start and perhaps in 2yrs 50% of the job may be done with the final cells still being converted around 5 years later.
I don't think buying one pot of supplement and then deciding, when you have used it up, that because you cannot see a difference immediately it's probably not doing any good. There is already far too much research online showing using too little of the wrong form of supplement for too short a time is ineffective.
We need to get back to basics and consider what level of Vitamin D, Omega 3 Magnesium etc would most likely have been present in the diet/lifestyle as our DNA evolved and how can we reasonably match those levels nowadays.
Dear Ted,
Those are excellent suggestions. I have written several articles about benefits of high levels of vitamin D, although I hadn't known about its benefit for peripheral neuropathy. I'm also written a couple of articles here about the benefits of omega 3, but have mentioned magnesium only in passing. I have personally used high levels of all three of these things for several years.
I do wonder, however, if my level of potassium might be too low. I will get it tested next week.
Best regards,
David
Make sure you always have adequate lighting so you can see your feet and what is under and immediately in front of your feet to compensate for your loss of proprioceptive information coming in directly from your feet. This means having the path to the bathroom adequately lit @ night and being VERY careful if you end up hiking before dawn or after dusk. (That's when those hiking poles might be helpful.) PN may have been a factor in your recent fall that necessitated the ER visit. When we talk to other people, we tend to look @ them, and this shifts our gaze away from what is around our feet.
I was in a Bone Builders class until recently (quit because it was so boring; I'm going to do it at home where I can listen to recorded books at the same time). The last exercise is always walking around a circle forward and backward, heel to toe (good exercise for when you're stopped for DUI). I was looking at my feet to make sure I got the heels right against the toes and the instructor said not to look at my feet.
She said if you're out in public and you look at your feet as you walk, purse snatchers will figure you're old and decrepit and they'll steal your purse (probably not a problem for David).
You can't please everyone.
Dear Karen,
I will try not to look at people when I talk with them on the trail from now on! And I have resumed using my trekking poles on all of my hikes. When I mentioned to my chiropractor that you thought I could improve my balance better by not using them, he said that I can work on balance in other ways. And I am.
David
It is a good general recommendation to look up and around while walking. It can increase one's awareness of surroundings as well as demonstrate robust balance/health to a would be attacker - not unlike stotting gazelles. However, having PN forces other more immediate safety issues to become primary. I realized, after i hit the ENTER key, i hadn't made it clear that my recommendations are specifically geared for people who have significant PN. Thanks for a different and also valid viewpoint about safety and ambulation. For people with PN, it can be a challenge to juggle both of these issues.
I think maybe one factor here is "significant." The endo who examined me a few years after Dx used the tuning fork. She said the sense of vibration is the first one to be compromised. So couldn't you have some loss of this sense but still enough feeling in your feet that you weren't apt to step on stones and nails and not know it?
I agree it's good to look up and around while walking. It reduces the number of times you walk into telephone poles. Besides, half of the pleasure of walking comes from looking at the scenery. I can look at my feet much more easily at home.
That doesn't mean one shouldn't be careful. I think carrying trekking poles is a good idea. You don't need to use them all the time, but they're there when you do.
Dear Gretchen,
Your point is well-taken. I don't have significant loss of sensation in my feet. I feel the smallest pebbles when I walk barefoot at home (and I know that people with neuropathy should never walk bareful, but I never thought I had neuropathy before).
And I am beginning to use my trekking poles on all of my hikes, including the one this morning.
Best regards,
David
My layman understanding is that "autonomic" neuropathy is nerve damage that occurs on the vagus nerve and nerves which extend from it. The autonomic system is responsible for automatic functions like heart rate, stomach emptying and the like. The other system of nerves is associated with muscles, skin and the like. When these nerves get damaged there is pain and/or a loss of sensation. Diabetes can damage both systems. It sounds like yours is not autonomic.
Hi, David--
Other causes for neuropathy you might consider:
Rapid normalization of blood sugar levels after years of being too high can cause neuropathy in and of itself (both peripheral and autonomic).
Also, excess Vitamin B6 can cause peripheral neuropathy. And it doesn't even take a lot to do so...if you take a "moderate excess" over a long period of time.
And excess Vitamin A can cause headaches, as can excess Vitamin D.
As a Type II and someone with PN, I now use a very useful scale that allows me to view my feet (magnified and lighted) each time that I weigh myself. I read about it in a newspiece in a British newspaper on Googlenews and was so taken with the concept that I tracked it down over the Net and ordered it immediately.
I've had it for over a month now and it's an excellent product--I've never done as well myself. The scale's called Insight (FocusOnYourFeet.com).
People with PN should check their feet very carefully every night--aside from watching diet, it's perhaps the most important thing to do every day.
I am not affliated with this company--just a satisfied customer.
Suda in NY
I was diagnosed with type II in 1996. I had neuropathy in my feet with tingling and stabbling pain. I read Dr Bernsteins book and took the recommended vitamins. (Alpha Lipoic Acid, Oil of Primrose and L carnitine) If you want to try what I did I suggest that you get his book because I might not have remembered the vitamins correctly. I continued taking these vitamins and after a few months the pain and tingling was gone and has not returned. I do have some mild numbness in my feet and see a foot doc every two months.
I have had diabetic retinopathy and was treated sucessfully for it with soft lazer last year. I do not know how much the vitamins have helped me as I believe that I still have some neuropathy like you have but no one has ever tested me the way you were. I am currently taking r-alpha lipoic acid and wonder if it is necessary? Do you have any thoughts on this?
I am now on a very low carb diet and not taking any medication except Novolog. I have found that some days I do not need the insulin and hope to eventually be off it. I went on insulin because I had some mild kidney damage caused by metformin according to my md. I now wish I had gone on insulin earlier as it is so easy.
I want to thank you for your many thoughtful columns. They have been very useful to me and I am sure to others. Bronwyn
Dear Bronwyn,
Thank you for directing me back to Dr. Bernstein's book (Dr. Bernstein's Diabetes Solution). I have it in my permanent library. When it first came out, I bought the print edition. But when it became available on the Amazon Kindle, I bought it there too. My reason was because the Kindle edition is searchable, and that's what I just needed to do with your mentioning his supplements for neuropathy.
He does not mention carnitine in the book. But he does recommend alpha lipoic acid and evening primrose for neuropathy. He says that because ALA depletes our bodies' stores of biotin, we need to take it with the ALA. He recommends 200 mg of ALA and 500 mg of evening primrose oil every eight hours or so, although he sometimes starts his patients on half this dose.
I already take ALA but haven't been taking biotin or EPO. Thanks to you and to Dr. B, I will now!
Best regards,
David
David, you might consider using R-ALA instead of ALA. In the second edition of his book he recommends using R-ALA as it is more effective. See page 238. He also remarks that "... German studies have shown dramatic improvements in diabetic neuropathy when ALA is administered intravenously in large doses over several weeks." You might want to try this?? but not at home as he notes. Page 241 has a useful chart for dosage. I have been using Insulow which already contains biotin. I am taking Faslodex for a breast cancer that recurred. It appears to be working as the cancer appears to have stopped growing. The problem tho is that the monthly faslodex shot increases my blood sugars. I am attempting to get off of insulin by eating a very low carb diet and so far my sugars are running about 235 in the morning. I use a shot of novolog of about 4 units and the sugars drop to about 135. I think that if I exercised that this situation will improve. Keeping healthy with diabetes is such a balancing act. Hope your headaches get better. Bronwyn
Dear Bronwyn,
Thank you for your follow up. I noticed that Dr. B referred to R-ALA, but passed over it. I will have to check it out now!
And my headaches do seem to be much less frequent and severe. Actually, only one moderate headache in the past two weeks. I appreciate your concern!
Best regards,
David
David
Sorry to hear about the neuropathy, that must be really annoying. Kudos to the neurologist for finding this out.
I wanted to point out something I'd read on George's (Ninjabetic) blog some time ago. I can't find the post, but he learned that because of his neuropathy he was tying his shoes too tight, and that was likely to increase circulatory problems.
I hope you can find an approach that minimizes problems for you.
Has anyone tried Lyrica for neuropathy? My neuropathy could be caused from use of prednisone or from chemo (12 years ago) or diabetes. No one seems to know. The chemo neuropathy just about went away from after 5 years. Took prednisone for 4 days and immediately had pain and stinging in hands and feet.
I would be interested in comments.
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Now, I would ask when was the last time you had your eyes checked and when was the last time your kidneys were checked.
We all let these things get away from us when we are feeling good. This is just a reminder. My doctor made me schedule my eye exam while in his office. I complied because I had not had it done in 5 years.
Bob (IA)
Dear Bob,
Those are excellent suggestions. I do get my eyes and kidney functions checked at least annually. In fact, my eye doctor checks them twice a year.
Thank you,
David